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General NPI Number Information
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NPI Number | 1396807582
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Entity Type | Organization
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Legal Business Name | RICHMOND-DENTAL ASSOCIATES
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 69089 N MAIN ST
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City | RICHMOND
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State | MI
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Zip | 48062-1146
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Country | US
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Telephone | 586-727-5898
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Fax | 586-727-8429
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Provider Business Mailing Address
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Address Line | 8547 HENDRIE BLVD
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City | HUNTINGTON WOODS
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State | MI
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Zip | 48070-1617
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Country | US
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Telephone | 586-491-6482
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAMUEL PAUL WEINER
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Credential | D.D.S.
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Telephone | 586-727-5898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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